Laparoscopic surgical instruments used for laparoscopic surgery vary significantly in design. Many previous designs for laparoscopic instruments are based on a design that is decades old, a design that was adopted to facilitate their use in upper airway endoscopy. These instruments are bent such that their handles are as much as 90 degrees out of alignment with their functional ends. These instruments were designed primarily to allow the surgeon to achieve a direct line of sight through a sheath and into the area where the instrument was intended to perform a surgical task. Because of this, the instruments were awkward and difficult to use for any extended period of time or for lengthy procedures. Moreover, they were not designed for complex internal surgical operations, such as suturing. As such, the function of these instruments largely dictated their form.
Surgical instruments incorporating a bent-handle design can be difficult to use, and can also cause injury to the surgeon. The design requires the operator to hold their wrist in awkward positions in order to manipulate the instrument. These positions are not only awkward, but they also encourage the development of carpal tunnel syndrome and chronic joint stress by positioning or orienting the hand in non-natural or non-functional positions. In attempts to alleviate often experienced pain and fatigue that are associated with use of the instrument in its intended manner, particularly in the event of long surgical procedures, many surgeons have resorted to holding the surgical instruments in a manner that is inconsistent with their design. This creates undesirable distractions, delays, and other problems during a surgical procedure.
Additionally, the bent-handle design does not efficiently translate force from the handle to the functional end of the instrument. Although the design of the instrument is intended to translate the forces that are applied to the handle to the functional end to perform a desired action, if the handle is bent out of line with the longitudinal axis of the functional end a portion of the applied force will be translated to movement of the instrument in a direction that is essentially perpendicular to this axis. This undesirable movement may be translated along the instrument to the functional end, thus compromising stability and inducing unwanted movement.
With the advent of fiber optics, the requirements for the bent handle design were largely eliminated. Rather than using a sheath to facilitate direct line of sight, surgeons today manipulate surgical instruments by means of a camera coupled to the surgical instrument that displays images onto a video screen. Given this change in technology regarding the visual aspects of surgery, it is surprising that the design of laparoscopic surgical instruments has largely remained unchanged. By utilizing modern technology, there no longer is a requirement that traditional or conventional designs be perpetuated. As such, there remains a need for a laparoscopic instrument design that is more ergonomic and simple to use.